Male Sexual Dysfunction Diagnosis and Tests
The initial step in diagnosing man’s sexual problem is for the doctor to perform a comprehensive history of symptoms. The doctor may do tests to rule out any medical conditions that can be a cause to the dysfunction. The physician may refer the patient to a specialist such as a neurologist, endocrinologist or urologist or even a counselor or a sex therapist.
Tests to Assess Male Sexual Problems
A number of tests are often utilized to study the extent and causes of a man’s sexual problems. They include:
Blood tests – Blood examinations are required to analyze hormone levels.
Vascular analysis – This is a test to evaluate blood circulation to the penis. If a blood vessel is seen to be blocked, blood flow to the penis becomes weak which can be a major contributing factor for erectile dysfunction.
Sensory testing – Sensory testing is very effective in helping evaluate the results of diabetic neuropathy (nerve damage). This test gauges the functionality of nerve impulses in a certain part of the body.
Rigidity testing and nocturnal penile tumescence – This is a procedure to detect erections that happen naturally during sleep. It can help the doctor know if a man’s erection problems are psychological or physical in nature.
Biothesiometry – This procedure uses an instrument called a biothesiometer to deliver a wide range spectrum of vibration stimuli to assess nerve sensitivity and function. A weak nerve sensitivity may imply nerve damage.
Penile duplex doppler ultrasound – This is a test to observe penile blood flow and can help determine if there is vessel blockage in the penile area.
Urinalysis – This is a test to measure testosterone, sugar and protein levels to detect testosterone inadequacy, kidney disease or diabetes all of which can result in erectile dysfunction or ED.
Vasoactive injection – This test is to determine if ED is caused by weak blood flow in the penis.
Dynamic infusion cavernosometry – This is a test to assess severity of blood leakage in the penis.
Cavernosography – This is also a test to detect for any leak in the veins in the penis.
Arteriography – This is a test for people who may require vascular reconstructive surgery that observes if the penile area suffers from arterial damage.
Bulbocavernosus reflex – This is a test to assess for any neural damage in the penis.
PSA – This is done to detect any infection in the penis or prostate enlargement.
Female Sexual Dysfunction (FSD) Diagnosis and Tests
A comprehensive review of a woman’s sexual and medical history is needed to correctly diagnose FSD. The medical and sexual history of the woman may entail existence of factors like sexually transmitted diseases, human immunodeficiency virus, fears of pregnancy, domestic violence and sexual preference as well as details pertaining to psychosocial issues and gynecologic or medical conditions that a woman might have. FSD can be due to several factors and the woman should be able to provide a good sexual history to her doctor.
FSD can be classified based on the start and duration of symptoms. It may be also important to know if symptoms are global or situational. Global symptoms refer to a collection circumstances and partners while situational symptoms talk about a specific setting or a particular partner.
A number of medical problems can help bring about FSD. For example, a vascular condition can cause weakened circulation to the genitalia leading to weakened arousal and retarded orgasm. Another problem that can cause FSD is diabetic neuropathy. Arthritis can make intercourse impossible since it causes discomfort and pain. Treating these conditions and informing patients about how they can affect sexuality is important in the treatment of FSD.
Physical Examination
A complete physical examination is needed to know the cause of FSD. The whole body and genital areas need to be examined. Examination of the genitals can be applied to localize and reproduce pain that is experienced by the woman during sexual activity and vaginal penetration. The physical attributes of the external genitalia should be observed including the distribution and amount of pubic hair and the turgor, thickness, texture and skin color of the genitals. The doctor then assesses the genital’s anatomy and internal mucosa cultures are taken if needed. Observation of the vaginal vault for discharge is done as well as attention to any signs of tissue atrophy and location of episiotomy strictures and scars and muscle. Adult females with severe dyspareunia and vaginismus may not tolerate well a normal bimanual and speculum examination. In lieu of these two exams, a monomanual examination utilizing one to two fingers can be performed. The monomanual (or bimanual) examination can shed light on anatomical information or any conditions the female has like vaginismus, adnexal and ovarian location and size, prolapsed, vaginal depth, internal muscle tone, cervical motion tenderness, uterine position and size and rectal disease.
Laboratory Tests
For FSD diagnosis, routine stool guaiac tests and Pap smears are essential. Knowing baseline hormone levels can be important as well.
Primary and secondary hypogonadism is essential to know FSD condition and can be measured with LH and FSH. A rise in these hormones may indicate primary gonadal failure and a decrease may mean problem of the hypothalamic-pituitary axis. Lower estrogen levels often cause dyspareunia, vaginal dryness and lower libido. Inadequacies in testosterone can likewise cause FSD, specifically, decreased sensation, arousal and libido. Levels of sex hormone-binding globulin (SHBG) increase with age but they lessen with the use of exogenous estrogens. Hyperprolactinemia can also be a factor for lessened libido.
Other Tests
A genital blood flow test can be done with use of a duplex Doppler ultrasonography. This test helps to know peak systolic and diastolic rates of circulation to the vagina, urethra, labia and clitoris. To ascertain the amount of lubrication in the vagina, a vaginal pH test can be helpful. Fluctuations in pressure-volume can determine dysfunction of vaginal tissue elasticity and compliance.
Dale Roach is a licensed acupuncturist and the founder of Dale Roach, MD,L.Ac in Larchmont, NY.